FINAL EXAM

Which vein drains blood from the foot, leg, and thigh' joining the femoral veing, making it the longest vein in the body?

Great Saphenous

A physcian needs to know a patient's Na, K, Cl, and CO2. What test would the physician likely order?

Electrolytes

In the organizational structure of the laboratory, who would act as the primary liaison between the medical staff and the laboratory staff?

Pathologist

What is the myocardium?

Heart muscle

What are the two main types of lympocytes found in the white blood cell population in human blood?

T-Cells and B-Cells

When a chemical spill occurs in the laboratory what should a phlebotomist consult prior to cleaning up the spill?

MSDS - Materials Safety Data Sheet

What initiates the normal contraction phase of the cardiac cycle?

SA Node - Sinoatrial Node

What are the two major areas of the clinical laboratory?

Anatomical and Clinical

What is the main anticoagulant for coagulation studies performed in the hematology department of the laboratory?

Sodium Citrate

The combining form path/o refers to:

Disease

A phlebotomist is assigned to the morning draw team. In completing this assignment, what is the area where the phlebotomist is likely to encounter the youngest patients?

NICU - Neonatal Intensive Care Unit

As a phlebotomist drawing blood in the dialysis unit you receive an accidental needle stick. What is the best course of action for you to follow immediately?

Notify the supervisor

In one word, what is the difference between plasma and serum?

Fibrinogen

The Emergency Room physician is examining a patient that is suspected of having a deep wound infection. What test would most likely be ordered by the physician to evaluate this condition?

CBC - Complete blood count

What is the largest artery in the body?

Aorta

The cellular elements in blood are the erythrocytes, leukocytes, and the thrombocytes. What is the primary function of each of the leukocytes?

Defense mechanism (producing antibodies)

The branch of medicine that deals with the study of nerves, the nervous system, and its diseases is:

Neurology

What form of outpatient PO coagulation therapy would be monitored and followed by a Prothrombin (PT) test conducted in the laboratory?

Coumadin

A phlebotomist taking an examination offered by a professional phlebotomy organization would be seeking?

Certification

What is the specimen collected by a phlebotomist?

Blood

Which arteries supply blood directly to the heart muscle?

Coronary Arteries

In addition to changing gloves between every patient, what else should be done by the phlebotomist?

Hand washing

What is the most common specimen analyzed in the hematology section of the laboratory?

Whole blood

What are the two main pathways of the coagulation cascade?

Intrinsic and Extrinsic

Word roots in medical terminology usually refer to:

Body parts (Body components)

Where are red blood cells produced in the adult human?

Bone marrow

What is the first thing to do in the event of a fire in the building where you are working?

R of RACE - Rescue

Personal protective equipment is put on and removed in reverse order. In what order are they put on?

Gown, Mask, Gloves

What does the term "Universal Precautions" refer to?

All bodily fluids and moist body substances are to be treated as potentially infectious.

Which blood vessels carry deoxygenated blood to the heart?

Veins

What is the upper and lower figures on a blood pressure reading?

A. Upper - Systolic B. Lower - Diastolic

Which type of blood vessel has the thickest walls?

Artery

What type of blood are most laboratory tests performed on?

Venous

The suffix -cyte means:

Cell

What does the suffix -ostomy mean?

Surgical opening

Which laboratory test monitors the antidepressant medication often used to treat bipolar disorder?

Lithium

What is the primary role of the thrombocytes?

Premote blood clotting or Hemostasis

What is the term used to describe a gross increase in the number of white blood cells in a patient?

Leukemia

What three things are required to complete the chain of infection?

A. Source B. Method of transmission and C. Susceptible host

The term dermatitis means:

Inflammation of the skin

What does a class ABC fire extinguisher contain?

Dry chemicals

The combining form for lung is:

Pulmon/o

What is measured with a sphygmomanometer?

Blood pressure

Which languages are the primary sources found in medical terminology?

Greek and Latin

Which antibodies would be found in the plasma of a person who is blood type A?

Anti-B antibodies

What is the recommended disinfectant for blood and bodily fluid contamination?

Bleach (1:10 Sodium Hypochlorite)

What type of patient is protected from infection by reverse or protective isolation?

Compromised or Immunocompromised

The prefic hypo- means:

Decreased

What sould a phlebotomist in a laboratory do if a patient calls to schedule a chest x-ray?

Give the caller the correct phone # and transfer them there

What does the term visceral refer to?

Internal organs

The artery of choice for measuring the pulse rate in an adult is the:

Radial

What is the large vein that returns blood from the head, neck, thorax, and upper limbs, to the right atrium of the heart?

Superior Vena Cava

What form of biologic hazard might be produced by centrifuging an uncapped blood specimen?

Aerosols

What is first defined when defining a word in medical terminology?

Suffix

Who is the person above the supervisor in a typical laboratory organizational chart diagram?

Laboratory Manager/Administrator

Which laboratory section performs ABO and Rh typing?

Blood bank

What type of laboratory performs highly specialized testing?

Reference Laboratory

Which laboratory department or section would perform a cardiac risk profile?

Chemistry

What is the only artery in the body that carries deoxygenated blood?

Pulmonary artery

The most important personal characteristic to ensure job security and advancement in phlebotomy is:

Flexability

What should a phlebotomist do before placing a call on hold?

Check for an emergency

Inflammation of the lining of the heart is called:

Endocarditis (Bacterio Endocarditis)

What type of isolation catergory always requires a gown to be worn?

Contact

What is another name for a heart attack?

Myocardial Infarction

To which body system does the combining form osteo/o refer?

Skeletal

The combining form nephro/o refers to which body system?

Renal

To which body system does the combining form aden/o refer?

Endocrine

A weakness in an arterial wall is called:

An Aneurysm

Which leukocyte had the highest concentration in normal blood?

Neutrophils

What determines a person's blood type?

Antigens

In the hospital setting, what service is the clinical laboratory a part of?

Professional

Hardening of the arteries is called:

Arteriosclerosis

Which healthcare settings are most phlebotomists employed?

Hospitals

The abbreviation PRN stands for:

Allowable as needed

A phlebotomist is pregnant. What patients should the phlebotomist not draw specimens from?

Radiology, Radiation therapy patients

Collecting a large evacuated tube using a 23-gauge needle or smaller may cause a sample to be:

Hemoloyzed

If a phlebotomist fails to check the requisition form prior to leaving the laboratory, he/she may not have:

Adiquate equipment

What might develop from using a lances that produces a puncture deeper than recommended?

Osteomyelitis

Before you draw a blood specimen you must always check the patient's id number and name on the :

Wrist band

Collection of a sufficient amount of blood by dermal puncture is most difficult from patients with poor peripheral circulation, or from patients who are:

Severly dehydrated

In what type of Vacutainer tube is the presence of a clot acceptable?

Red top

What is the primary antiseptic for routine Venipuncture?

70% Isopropyl Alcohol

A tourniquet should be placed 3-4 inches above the venipuncture site, and remain on the patient's arm no longer than:

One minute

What is the maximum temperature when warming a dermal puncture site?

42 degrees C

Before requesting assistance from another phlebotomist, to obtain an adequate amount of blood by dermal puncture, how many attempts should a phlebotomist make?

2

Indication that the tourniquet is tied too tightly is seen by the appearance on the patient's arm during site selection of:

Petechiae

What is not acceptable as a skin puncture device?

Surgical blades

Forcing blood from a syringe into a evacuated tube may cause the specimen to be:

Hemolyzed

Manufacturers of evacuated collection tubes guarantee the intergrity of the anticoagulant and vaccum in the tube until the expiration date. What is the term used to refer to groups of evacuated tubes that are manufactured at the same time?

Lot

What should be done to prevent a vein from rolling prior to needle insertion?

Anchor the vein

When a puncture is made through a previous site what is increased?

Risk of infection (Potential infection)

A device normally used in venipuncture, and that is not used in microcollection techniques is the:

Tourniquet

What is the most important procedure in phlebotomy?

Patient Identification

Blood collected by dermal puncture most closely resembles:

Arterial blood

The anticoagulant present in a light-blue stopper tube preserves the labile coagulation factors. What is this anticoagulant?

Sodium Citrate

The vacutainer tube that must always be completely filled is the:

Light Blue

A large, rigid cord located during palpation indicates a:

Tendon

Blood will run down the finger during a finger puncture if the phlebotomist fails to puncture:

Across the fingerprint

Before beginning blood collection in dermal puncture, the first drop of blood should be:

Wiped away

What may be caused by prolonged application of a tourniquet?

Hemolysis

What is the maximum safe length of lancets used for heel puncture?

2 mm.

The winged infusion set (Butterfly) would be primarily used to collect blood from a patient's:

Hand

What is the tube of choice for metal analysis?

Royal Blue

When collecting specimens in a patient's room, tubes are routinely labeled immediately:

After blood is collected

During dermal puncture, why is the first drop of blood wiped away?

Because it's diluted with tissue fluid

A sharps container is not needed when performing dermal punctures using a:

Laser lancet

Identification of a patient is never made by the patient's:

Bed sign

In the evacuated tube system, what does blood flow into the tube depend on?

Vaccum in the tube

The gray stopper top tube contains sodium fluoride in addition to an anticoagulant. The purpose of this compound is to preserve glucose. What is it called?

Antiglycolitic Inhibitor

The major vascular are of the skin is the:

Dermal Subcutaneous Juncture

What part of the foot is not an acceptable dermal puncture site on an infant:

Arch

Infants should never be identified by the:

Id band on the bassinet

The meaning of palpate is to examine by:

Touch

In order to prevent contact with bone, what must be controlled in a dermal puncture?

Depth

When collecting blood from a patient with small, fragile veins, what is the appropriate needle size?

23-gauge

What is an example of improper disposal of venipuncture supplies and equipment?

Recapping the needle

What bone is at the posterior of the heel?

Calcaneous

Blood should never be drawn from a patient who is:

Standing

What is the most important purpose of a procedure requisition form?

Authorization

Collection of excess blood from a premature infant can cause:

Anemia

Failing to adequately invert a lavender stopper tube after collection will produce a specimen that is:

Clotted

When organizing equipment at the patient's bedside, it is important to have readily available extra:

Evacuated tubes

The most acceptable puncture site for a 6-month old infant is the:

Heel

All phlebotomy procedures begin with authorization to perform the procedure by the:

Requisition form

The amount of anticoagulant is decreased when collecting coagulation tests from a patient with a hematocrit greater than 55%, or from a patient with:

Polycythemia

Warming the site of a dermal puncture will cause the flow of arterial blood at the site to:

Increase

What is the vein of choice for routine venipuncture?

Median Cubital

Serum or plasma appearing red after centrifugation suggests that falsely elevated values will result in:

Potassium

Incorrect collection of blood from a patient who had had a mastectomy can result in the patient developing lymphedema, lymphostasis, or:

Infection

What might an infant with falsely negative PKU test most likely be affected with?

Severe mental retardation

When preparing a blood smear, what is the correct angle of the spreader slide?

30 to 40 degrees

While performing a venipuncture, the phlebotomist notices bright red blood spurting into the tube. What should the phlebotomist do after withdrawing the needle?

Apply pressure for 10 minutes

What situations occurring during a phlebotomy visit to a patient room should be reported to the nursing station?

The Duke bleeding time method has been replaced with the template bleeding time because the template method is more:

Standardized

The high red blood cell counts normally seen in newborns may cause decreased levels of:

Glucose

What can be caused by using a small-gauge needle with a large evacuated tube?

Hemolysis

A patient who appears pale and has cold, damp skin may develop:

Syncope

Disturbing the platelet plug when performing a bleeding time test wil result in a bleeding time result that is:

Prolonged or lengthened

Most states require testing of newborns for:

PKU - Phenylketonuria

Allowing blood to leak from a vein into the surrounding tissue during venipuncture, frequently caused my improper needle removal, may result in:

A hematoma

As a phlebotomist you encounter a comatose patient with no ID band. What should you do?

Ask the nurse to band the patient

What is the pressure at which the blood pressure cuff should be maintained when performing a template bleeding time?

40 mmHg

What is the test method used by filter paper screening tests for PKU?

Bacterial growth

Collection of specimens from diabetic patients, cardiac patients, or patients with coagulation disorders is not recommended from:

Leg veins

A patient taking aspirin can cause a bleeding time that is falsely:

Prolonged or Lengthened

Failure to completely fill the filter paper circle for a newborn screening test can cause results that are:

Falsely decreased

What is the maximum number of attempts that a phlebotomist should make to collect a specimen?

2

A phlebotomist can interrupt a physician-patient visit if the collection is a:

STAT or Timed collection

In what disease does multiplication of parasites within red blood cells occur?

Malaria

Which items will affect the quality of neonatal bilirubin test results?

Exposure to light, Collected at wrong time and Hemolysis

When collecting blood from a patient with an IV, the phlebotomist should not draw from:

Above the IV

When performing a bleeding time on an adult, the incision is made horizontal or parallel to the:

Anticubital crease

Specimens collected by venipuncture that require preparation of a blood smear are collected in tubes containing:

EDTA - Etheylaminediaminetetraaetic Acid

A phlebotomist is attemtping to transfer blood from a syringe into an evacuated tube. While puncturing the rubber stopper the phlebotomist should not:

Hold the tube in their hand

A specimen collected from a patient who has recently eaten may appear:

Lipemic

A bleeding time that continues for 15 minutes should be:

Discontinued

What is the acceptable amount of blood used to fill a filter paper circle for newborn screening tests?

One drop

Physician approval is required prior to collecting blood from:

Leg veins

On what portion of a blood smear should microscopic examinations be performed?

Feathered edge

A suitable blood smear should have a smooth film of blood without ridges, holes, or streaks, and and edge that is lightly:

Feathered

If a patient requests a drink of water, what should the phlebotomist do?

Report the request to the nursing station

Specimens that must be collected at specific times are theraputic drug levels and those that exhibit:

Diurnal variation (sercadian rhythm)

When preparing a blood smear, where is spreader placed?

In front of the drop of blood

Amber-colored microtainer tubes are used to collect specimens for:

Bilirubin

Collecting blood from an area containing a tattoo could result in:

Infection

Blood i removed from the bleeding time incision with filter paper by:

Wicking

In which type of vacutainer tube would specimens not be rejected by the laboratory for clots?

Red

On patients taking diuretics, a chemical level that is frequently monitored is the:

Potassium

Preparation of the blood smear using a slide that is not clean will most likely result in a smear with:

Holes

Newborns that appear jaundiced have increased levels of:

Bilirubin

When collecting blood from a patient with a very edematous right arm and a large hematoma in the antecubital are of the left arm, where should the phlebotomist collect the specimen?

Below the hematoma

The surgical fusion of a vein and artery frequently seen in dialysis patients is called a:

Fistula

Pushing instead of pulling the blood with the spreader slide produces a blood smear with a feathered edge containing:

Streaks

What term means an abnormal accumulation of fluid in the tissues?

Edema

When preparing a blood smear, lowering the angle of the spreader will result in a smear thickness that is:

Decreased

What is the time period patients are most likely to be in a basal state?

Early morning

A bleeding time is performed to evaluate the function of the:

Platelets

A pecimen was collected in the newborn nursery under the bili light. A bilirubin collected from a jaundiced infant in this case may have results that are:

Low or normal

Using a 20-gauge needle and a 10mL tube on a small vein may cause a:

Collapsed vein

Phlebotomists working in central processing and entering data for Medicare and other collections, may be required to classify tests using a:

CPT

When a patient has a unit of blood drawn prior to surgery with the understanding that the unit may be given back during surgery, the collection is called:

Autologous

A phlebotomist who cannot locate a patient on whom a cortisol level is scheduled for collection at 1000 should:

Return the requisition to the nursing station for rescheduling (Report to nuring station)

What item of equipment is likely to be located within the central processing area?

Centrifuge

To obtain an accurate 24-hour uring specimen, the patient is instructed to begin and end the collection with:

An empty bladder

What is one specimen that must be protected from light?

Bilirubin, Vitamin A or Vitamin D

One of the most difficult phlebotomy procedures is the collection of blood cultures. What is the purpose of this test procedure?

R/O possible septicemia

A phlebotomist who is unsure of the instructions to give a patient regarding collection of a specimen should consult the:

Laboratory Procedures Manual

Midstream clean-catch urine specimens for culturing are delivered to the:

Microbiology department

When blood is inoculated into blood culture bottles using a butterfly apparatus, the bottle that is inoculated first is the:

Areobic

Which test order type is classified as the highest priority?

STAT

What is the fluid collected from the abdominal cavity?

Peritoneal

Three blood cultures from a patient requiring ASAP administration of antibiotics are collected:

At the same time, different sites

A laboratory uses Quest Diagnostics as a reference laboratory. What should be checked for the correct procedure to follow for processing specimens to be sent to a reference laboratory?

Reference Laboratory Manual

Urine specimens that cannot be tested within 2hours should be:

Refrigerated

What is the test that must be placed in ice and water immediately after collection?

Lactic Acid (Also ACTH, Ammonia, and Blood gases)

To monitor changes in a patient's hemoblobin level, a phlebotomist may be requested to collect specimens:

At specific times

When a semen specimen is delivered to the laboratory, the phlebotomist should record the:

Time of collection

When does timing for a GTT begin?

After the PT finishes drinking the glucola

In a patient with Polycythemia, the amount of serum obtained after centrifuging a tube of blood will be:

Decreased

What type of container should not be given to hospital outpatients for the collection of 24 hour fecal specimens, although this type of container may be used by reference laboratories?

Paint can style

Specimens drawn from a patient to analyze cold agglutinins must be kept:

Warm

Peak and trough levels are collected to monitor levels of:

Theraputic drugs

A small ampule of transport media is present in throat swab collection kits. What is the purpose of this media?

Keep bacteria alive

A fasting (baseline) specimen for a GTT is drawn at 0600, and the patient finishes drinking the glucose at 0645. What is the correct time to draw the 1-hour specimen?

0745

Many non-blood specimens such as CSF and other body fluids must be analyzed immediately. This is to prevent loss of:

Glucose and Cellular Elements

A pH of 9.5, a specific gravity of 1.002, or a blue-green urine color with a urine drug collection specimen might suggest:

Adulteration

When blood is inoculated into blood culture bottels using a syringe, which bottle is inoculated first?

Anerobic (w/o oxygen)

Why are major phlebotomy rounds scheduled early in the morning?

Pt's are at a basal state

When collecting sweat electrolytes, the collection site is cleansed before and after stimulation with:

Deionized water

When is a therapeutic drug trough level drawn?

Prior to druge administration

What is the distribution of a CSF specimen in tubes labeled 1, 2 and 3?

1. To Chemistry, 2. To Microbiology and 3. To Hematology

Chain of custody refers to the documentation of specimen handling for specimens that are:

Forensic

What is the classification for a patient who is not allowed to have food or water for a specified time?

NPO

Failure to tightly seal specimens for sweat electrolytes during collection and transport will allow evaporation to cause:

Increased values

How many specimens are collected from a patient receiving a 2-hour postprandial glucose test?

2

To prevent contamination by cellular constituents, serum or plasma should be seperated from cells by centrifugation within:

120 minutes or 2-hours

A blood specimen for DNA analysis to determine paternity is considered to be:

Legal or Forensic

Plasma cortisol levels are scheduled to be drawn between 0800 and 1000 because cortisol is a metabolite that exhibits:

Diurnal variation

What is the process of assigning of specimen identification numbers and distribution of specimens in the laboratory?

Assessioning

How are specimens that require chilling immediately after collection handled?

Ice and Water

How much blood is collected from a person donating a unit of blood?

405-495 mL

What is the most important consideration when collecting a blood culture?

Aseptic technique

A phlebotomist in central processing receives an SST tube with a requisition for tests performed in chemistry and at a reference laboratory. What should the phlebotomist do?

Aliquot the specimen

What is the order in which cleansing solutions are applied to a patient's arm before and after collection of a blood culture?

Alcohol, Iodine, Alcohol

What is a donaor physical measurement that would most likely disqualify them from donating blood?

Wt. and hemoglobin too low, and BP or Temp too high

Some blood culture collection systems contain a resin. What is the purpose of this resin?

To deactivate or inactivate antibiotics

The process in which a person donates a specific blood component and the remainder of the blood is returned to the donor is called?

Apheresis

What is the department within the laboratory to which blood cultures are delivered after collection?

Microbiology

What process might be used in the treatment of Polycythemia or Hemochromatosis?

Therapeutic Phlebotomy

The specimens collected during the GTT after the patient drinks the glucose will be analyzed at the end of the test. What type of vacutainer tube should the baseline glucose and all of the specimens of the test be collected in:

Gray

Glucose and Sodium values on a previously normal patient became markedly elevated when collected at 1500. An investigation of the delta check resulting from this situation would most likely discover that the specimen was collected:

Above an IV

Monitoring the quality of patient care is a function of:

Quality Control (QC)

What is a test that cannot be performed by POCT instruments?

Platelet counts

What part of a routine urinalysis would a phlebotomist not be authorized to perform under CLIA?

Microscopic analysis

A phlebotomist who forcibly tries to obtain blood from a patient who refuses can be charged with:

Criminal battery

What is failure to give reasonable care to a patient by a healthcare provider?

Negligence

Very serious errors in test results will occur if plasma from a lavender top tube and a light-blue top tube is combined in a test for:

PT, PTT

What should a phlebotomist provide when instructing a patient prior to the collection of a specimen for occult blood testing?

A list of foods and meds to avoid

What is the standardization of an instrument used for POCT?

Calibration

How would a phlebotomist error resulting in a hemolytic transfusion reaction be classed?

Root cause

Collection of specimens, transporting specimens, and processing specimens, are all variables associated with phlebotomy and would be classed as:

Pre-analytical

The HemoCue can accurately measure hemoglobin concentration in patients with high white blood cell counts because that reaction:

Is read at two different wave-lenghts

How does a laboratory procedures manual differ from a test kit package insert?

Recording test results

A phlebotomist obtained blood from a confused patient. After collecting the blood the phlebotomist leaves the bed rail down and leaves the room. In what way might the phlebotomist be held accountable?

Negligence

The medical code of ethics for phlebotomists dictates that they will perform skills within their:

Job description

Documentation of daily refrigerator and freezer temperature records, as well as centrifuge calibration and maintenance are required by:

Accreditation

The purpose of enzyme immunoassay tests for pregnancy is the detection of:

HcG - Human Chorionic Gonadotropin

What should the phlebotomist consult to determine the proper maintenance of a Glucometer?

Package insert

The expiration date on a box of evacuated tubes represents the last day that the manufacturer guarantees:

Correct performance

How would collection of a blood specimen from a site above an IV be detected?

Delta Check

Why are two swabs usually collected for rapid streptococcus testing?

One for rapid test, and one for culture

Proficiency testing is required for all levels of CLIA complexity except:

Waived

What are patient's who extend their arms after a phlebotomist has explained a venipuncture procedure doing?

To avoid a false positive result in an occult blood sample, what should the patient avoid for one week prior to collection?

Aspirin

What is the advantage of a rapid group A Streptococcus kit as far as results are concerned?

Available sooner

What is ther term used to refer to an unexpected patient death that is not related to the patient's illness?

Sentinel Event

The most serious error that a phlebotomist can make is:

Failure to correctly identify a patient

Failure to obtain quality control results that are within acceptable limits when performing a blood glucose may be caused by the control covering onle half of the testing area; by prolonged exposure of reagent strips to room air, or:

Refrigeration

What is a phlebotomist performing when running a test on a standardized sample recieved from a monitoring agency?

Proficiency Testing

What is the failure to provide a standard of care that is due to a patient by a healthcare provider?

Malpractice

The Health Insurance Protability and Accountability Act (HIPPA) primarily would affect phlebotomists when they are:

Reporting test results

Rapid tests for group A streptococcus detect Group A streptococcus?

Antigens

If a phlebotomist is not performing a test correctly, this will be detected through:

Quality Control (QC)

How are laboratory centrifuges calibrated?

Tachometer

The program established by a healthcare organization to guarantee appropriate patient care is: